Drug dependence treatment and HIV prevention in Kenya

30 March 2011 - Globally, an estimated 16 million people abuse drugs by injection, and of that total, some 3 million live with HIV. The use of contaminated injecting equipment is a major cause of HIV transmission in many countries and accounts for up to 10 per cent of all HIV cases worldwide. UNODC, as the leading United Nations agency in countering illicit drugs and the transmission of HIV through intravenous drug abuse, works with countries to review and develop laws, policies and standards of care that enable them to establish effective services for people who inject drugs.

During his first visit to East Africa since taking office as head of UNODC, Executive Director Yury Fedotov visited the Nairobi Outreach Services Trust in Kenya, a non-governmental organization working to prevent HIV among injecting drug abusers and other vulnerable sections of the population in Nairobi.

The visit follows the recently concluded session of the Commission on Narcotic Drugs, at which Mr. Fedotov stressed the important role of civil society in preventing drug abuse in all regions of the world: "We must continue to expand efforts to prevent drug dependence and strive to provide all drug abusers with the treatment, care and support they need. As we move to achieve this, we regard the community of non-governmental organizations as a key partner and a powerful voice in reaching the people whom UNODC ultimately works to serve."

While considerable progress has been made in the global HIV response over the past two decades, coverage of the most effective HIV interventions for men and women who inject drugs remains low. Only 8 per cent of injecting drug abusers receive opioid substitution therapy and a mere 4 per cent are treated for HIV.

For that reason, the work of UNODC, States and non-governmental partners in the areas of drug demand reduction and prevention of HIV among injecting drug abusers is critical.

In January 2011, the UNODC Regional Office for Eastern Africa supported the Government of Kenya and various partners in responding to a crisis in Mombasa resulting from a sudden decrease in the availability of heroin in Coast Province. Recently, the Government decentralized drug dependence treatment to 12 primary health-care centres in Mombasa in response to a sudden upsurge in demand for treatment. In addition, an innovative approach has been adopted to reduce the number of new HIV infections among injecting drug abusers by providing free access to HIV prevention and treatment services. Also in January 2011, the Government announced that it would adopt effective interventions including opiate substitution therapy and needle and syringe programmes to further reduce HIV infection among injecting drug abusers.

While such activities and achievements are commendable, access to HIV services in many parts of the world is often impeded by factors such as restrictive policies, poor availability and high cost of services and compulsory or ineffective approaches to drug dependence treatment, to mention but a few. In that regard, Mr. Fedotov calls on more Governments around the world to adopt evidence-informed, human rights-based and gender-responsive policies and programmes in the area of drug dependence treatment and HIV prevention: "In many countries, legislation and practices continue to result in widespread discrimination towards people who use drugs. Drug users remain socially marginalized, subjected to violations of their basic rights and incarcerated in large numbers or confined to detention centres. This undermines effective HIV responses and stops users from accessing services needed to prevent new HIV infections. It is crucial that these actions be stopped."